Avenues for Long COVID Testing and Possible Treatments

Written By Brendan Courneene
 
LNG COVI SYMPTOMS

What is Long COVID?

COVID long hauler is a term used to describe people who experience lingering symptoms of COVID-19 weeks or even months after they have recovered from the initial infection. And although we have a constellation of symptoms that create a diagnosable name, we are far from a standardized treatment for Long COVID

What causes Long COVID?
The one main explanation most researchers can identify is inflammation. However, inflammation normally responds well to a number of treatments that have tired and failed in the treatment of Long COVID. Understanding that “Long Hauler’s” includes multi-organ involvement and side effects, we must take a holistic approach to the proper diagnosis and treatment of the condition.

Recap on Acute COVID-19 Inflammation

The renin–angiotensin system (RAS), an essential enzymatic cascade involved in maintaining blood pressure and electrolyte balance, is involved in the pathogenicity of COVID-19, since the angiotensin-converting enzyme II (ACE2) acts as the cellular receptor for SARS-CoV-2 in many human tissues and organs, specifically the heart, kidneys, and lungs. With alterations in lung inflammation and electrolyte imbalance, COVID-19 is able to cause a significant amount of oxidative damage in a short period of time.

Iron Metabolism, COVID-19 Infection, and Long COVID
Iron is an essential mineral that plays a vital role in many bodily functions, including oxygen transport, energy production, and cell growth and repair. Iron can exist in two forms: ferric iron (Fe3+) and ferrous iron (Fe2+). Ferric iron is the oxidized form of iron, while ferrous iron is the reduced form.

COVID-19 can impact the conversion of iron from ferric to ferrous in a number of ways. For example, the virus can cause inflammation, which can lead to a decrease in the availability of oxygen in the tissues. This can make it difficult for the body to reduce ferric iron to ferrous iron, thus causing increased levels of the unusable iron. This

Iron Status, Gender, and Symptoms
On average, females are far more likely to have lower iron stores due to menstrual bleeding. On the other end of the spectrum, men are significantly more likely to experience iron overload and hemochromatosis. Both populations can be susceptible to anemia (low red blood count) with COVID-19 infection but can present differently.

Men and Symptoms
We know that men are more likely to undergo acute organ damage with COVID-19 infections, which can be explained by anemia of inflammation causing increased ferric iron (Fe3+) production damaging organ systems. Anemia of Inflammation, iron overload, and Men with Long COVID share similar symptoms (fatigue, irregular heart beat, joint pain, unexplained weight loss, and erectile dysfunction). Detoxification of high levels of ferric iron is a slow process and it allows for lack of tissue oxygenation effecting organs like the testes, which contributes to lower testosterone levels. However, the hormone disruption and length of Long Covid symptoms are consistent with other conditions effecting testicular blood flow.

Women and Symptoms:
With a lower average iron store, prior to an infection known to cause anemia of inflammation women’s symptoms are more clinically consistent with classic serve iron deficiency; weakness, shortness of breath, fatigue, chest pain, and palpitations. However, as holistic

Understanding Iron Testing + Limitations:

  • serum iron test — measures the iron in your blood. (both ferric and ferrous)

  • ferritin test — measures the amount of stored iron in your body. (both ferric and ferrous)

  • transferrin test — measures how well your body transports iron in your blood.

  • total iron-binding capacity test (TIBC) — is another way to measure how well your body transports iron.

Iron metabolism can change quickly within the course of an infection. Supplementation alone should not be considered safe without direct supervision by a medical provider, as overload is possible.

Contributing Factors to Persisting Symptoms:

Aside from acute symptoms of low oxygenation and organ damage after an infection, individuals are able to experience Long Covid for 2+ years post infection or vaccination. The aforementioned changes in cellular electrolytes and iron metabolism are able to linger longer on average for women and contribute to significant changes in the endocrine system - lower thyroid function and male/female hormones. Working with a holistic provider to evaluate the multifactorial nature of this condition is critical from responsible diagnosis and effective treatments.

Information provider here is for educational purposes only and is not be taken as medical advice. You should consult with your primary care provider before taking any medication, supplement, or dietary change.

 
Brendan Courneene
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